Brief Patient History: Mr. K is a 42-year-old

Brief Patient History:

Mr. K is a 42-year-old Asian man in your city on a business trip. He is transported to your facility from his hotel because of a witnessed grand mal seizure. Paramedics administered lorazepam in the field. Mr. K’s wife reports by phone that he is in good health and that she is not aware that he takes any medications regularly. She states that he recently quit drinking alcohol because of pressure from the family. She also comments that she thinks he takes alprazolam to calm his nerves once in a while.

Mr. K is admitted to the critical care unit from the emergency department with hypertension, restlessness, mental confusion, paranoid ideations with rambling speech, and visual and auditory hallucinations. Mr. K’s skin is warm and moist. Intravenous administration of thiamine, folic acid, multivitamins, and magnesium was begun in the emergency department. Physician orders were written for lorazepam every 6 hours and clonidine every 4 hours as needed for delirium-related symptoms.

Mr. K’s baseline vital signs are as follows: blood pressure of 190/92 mm Hg, heart rate of 130 beats/min (sinus tachycardia), respiratory rate of 26 breaths/min, and temperature of 98.8 degrees F. Pulse oximetry oxygen saturation is 90% on 4 L/min oxygen using a nasal cannula. Assessment of delirium with the Confusion Assessment Method indicates the presence of acute and fluctuating changes in mental status, inattention, and disorganized thinking. The Sedation-Agitation Scale score is 5. Serum and urine toxicology studies are negative for ethyl alcohol, cannabis, and opioids; urine is strongly positive for benzodiazepines. The sodium level is 135 mmol/L, potassium level is 4.3 mmol/L, chloride level is 84 mmol/L, carbon dioxide level is 26 mEq/L, calcium level is 8 mg/dL, magnesium level is 2.0 mg/dL, and gamma-glutamyl transferase level is 80 IU/L.

Medical Diagnosis:

Mr. K is diagnosed with delirium tremens caused by alcohol and benzodiazepine withdrawal.

Questions:

After reviewing the case study, answer the following questions in a word document. Include citations to support your analysis as needed.

1. What major outcomes do you expect to achieve for this patient?
2. What problems or risks must be managed to achieve these outcomes?
3. What interventions must be initiated to monitor, prevent, manage, or eliminate the problems and risks identified?
4. What possible learning needs do you anticipate for this patient?